Community Interventions

Overcoming Access Barriers to Health Services Through Membership-Based Microfinance Organizations: A Review of Evidence from South Asia

It is a challenge for the poor to overcome the barriers to accessing health services. Membership-based microfinance with associated health programmes can improve health outcomes for the poor. This study reviewed the evidence
published between 1993 and 2013 on the role of membership-based microfinance with associated health programmes in improving health outcomes for the poor in South Asia. [from abstract]

Challenges to the Implementation of the Integrated Management of Childhood Illness (IMCI) at Community Health Centres in West Java Province, Indonesia

The integrated management of childhood illness (IMCI) is a comprehensive approach to child health, which has been adopted in Indonesia since 1997. This study aims to provide an overview of IMCI implementation at community health centres (puskesmas) in West Java province, Indonesia.[from abstract]

Note: Resource is on 161-170.

Rwanda's Evolving Community Health Worker System: A Qualitative Assessment of Client and Provider Perspectives

Community health workers (CHWs) can play important roles in primary health care delivery, particularly in settings of health workforce shortages. However, little is known about CHWs’ perceptions of barriers and motivations, as well as those of the beneficiaries of CHWs.[from abstract]

Which Intervention Design Factors Influence Performance of Community Health Workers in Low- and Middle-Income Countries? A Systematic Review

Community health workers (CHWs) are increasingly recognized as an integral component of the health workforce needed to achieve public health goals in low- and middle-income countries (LMICs). Many factors influence CHW performance. A systematic review was conducted to identify intervention design related factors influencing performance of CHWs. [from abstract]

Perceived Barriers to Accessing Specialized Medical Care in Rural Communities of Ontario: A Pilot Study

Rural residents seeking health care face barriers due to a shortage of healthcare professionals and the travel distance required to obtain medical services. A pilot study was conducted to examine rural residents’ ability to access specialized care. This quantitative pen and paper survey was implemented in two communities with similar health care infrastructure(Tweed, Ontario and Hensall, Ontario). [adapted from abstract]

Community Health Workers Programme in Luanda, Angola: an Evaluation of the Implementation Process

The Community Health Workers (CHWs) Programme was launched in Luanda, Angola, in 2007 as an initiative of the provincial government. The aim of this study was to assess its implementation process. This is a case study with documental analysis, CHWs reports data, individual interviews and focal groups. [from abstract]

Managing Quality in Community Health Care Services

Community health care services provide vital care out of hospital for millions of people. From children’s services to care for older people and end-of-life support, the community sector plays a key part in meeting the challenges facing our health and care system. This report presents findings from a small-scale study into how quality is managed in community services. It explores how community care providers define and measure quality and recommends important next steps to support better measurement and management of quality. [from introduction]

Traditional Birth Attendance (TBA) in a Health System: What Are The Roles, Benefits and Challenges: A Case Study of Incorporated TBA in Timor-Leste

The study utilized a non-systematic review of the literature using key words such as community health
workers, traditional birth attendants, reproductive health, child health and health outcomes. A case study from
Timor-Leste was also used. [from abstract]

Developing a Pilot E-Mobile App for Dementia Caregiver Support: Lessons Learned

This paper discusses the development of Story-Call, a pilot e-mobile multimedia App, or application, for community-based dementia caregiver support, designed to offer reassurance, information and services to caregivers, and facilitate supportive efforts and implementation of other interventions by nurses and therapists. [from abstract]

Do Community Health Workers Perceive Mechanisms Associated with the Success of Community Case Management of Malaria? A Qualitative Study From Burkina Faso

The use of community health workers to administer prompt treatments is gaining popularity in most sub-Saharan African countries. Their performance is a key challenge because it varies considerably, depending on the context, while being closely associated with the effectiveness of case management strategies. What determines community health workers’ performance is still under debate. Based on a realist perspective, a systematic review recently hypothesized that several mechanisms are associated with good performance and successful community interventions.

Community Health Nurses’ Learning Needs in Relation to the Canadian Community Health Nursing Standards of Practice: Results From a Canadian Survey

This paper examines Canadian CHNs learning needs in relation to the 2008 Canadian Community Health Nursing Standards of Practice (CCHN Standards). It answers: What are the learning needs of CHNs in Canada in relation to the CCHN Standards? What are differences in CHNs’ learning needs by: province and territory in Canada, work setting (home health, public health and other community health settings) and years of nursing practice? [from abstract]

Primary Care and Public Health Services Integration in Brazil’s Unified Health System

We examined associations between transdisciplinary collaboration, evidence-based practice, and primary care and public health services integration in Brazil’s Family Health Strategy. We aimed to identify practices that facilitate service integration and evidence-based practice. [from abstract]

Development of a Smartphone-Enabled Hypertension and Diabetes Management Package to Facilitate Evidence-Based Care Delivery in Primary Healthcare Facilities in India: A Formative Research to Inform Intervention Design

Hypertension and diabetes have become a major public health challenge in India. This research work aims to develop a feasible and scalable intervention for hypertension and diabetes, tailored to primary care settings in India. [from abstract]

Factors Affecting the Performance of Community Health Workers in India: a Multi-Stakeholder Perspective

Community health workers (CHWs) form a vital link between the community and the health department in several countries. In India, since 2005 this role is largely being played by Accredited Social Health Activists (ASHAs), who are village-level female workers. Though ASHAs primarily work for the health department, in a model being tested in Rajasthan they support two government departments. Focusing on the ASHA in this new role as a link worker between two departments, this paper examines factors associated with her work performance from a multi-stakeholder perspective. [from abstract]

“Volunteers Are Not Paid Because They Are Priceless”: Community Health Worker Capacities and Values in an AIDS Treatment Intervention in Urban Ethiopia

This article analyzes community health workers’ (CHW) capacities for empathic service within an AIDS treatment program in Addis Ababa. I show how CHWs’ capacities to build relationships with stigmatized people, reconcile family disputes, and confront death draw on a constellation of values, desires, and emotions encouraged by CHWs’ families and religious teachings. I then examine the ways in which the capacities of CHWs were valued by the
institutions that deployed them.

How Do Health Extension Workers in Ethiopia Allocate Their Time?

In 2003, the Government of Ethiopia launched the Health Extension Programme and introduced a new cadre, health extension workers (HEWs), to improve access to care in rural communities. In 2013, to inform the government’s plans for HEWs to take on an enhanced role in community-based newborn care, a time and motion study was conducted to understand the range of HEW responsibilities and how they allocate their time across health and non-health activities. [from abstract]

A Scenario-Planning Approach to Human Resources for Health: The Case of Community Pharmacists in Portugal

This study aims to design three future scenarios for Portuguese community pharmacists, recognizing the changing environment as an opportunity to develop the role that community pharmacists may play in the Portuguese health system. [from abstract]

Making the Post-MDG Global Health Goals Relevant for Highly Inequitable Societies: Findings From A Consultation with Marginalized Populations in Guatemala

Achieving health goals in a context of deep-rooted inequality and marginalization requires going beyond the simple expansion of health services and working with developing trusting relationships between health service providers and community members. Involving community members in decision-making processes that shape policies will contribute to a
larger process of community empowerment and democratization. [from abstract]

‘Your Health Our Concern, Our Health Whose Concern?’: Perceptions of Injustice in Organizational Relationships and Processes and Frontline Health Worker Motivation in Ghana

Taking a perspective of frontline health workers as internal clients within health systems, this study explored how perceived injustice in policy and organizational matters influence frontline health worker motivation and the consequent effect on workers’ attitudes and performance in delivering maternal and neonatal health care in public hospitals. [from abstract]

A Community Health Worker “Logic Model”: Towards a Theory of Enhanced Performance in Low- and Middle-Income Countries

There has been a resurgence of interest in national Community Health Worker (CHW) programs in low- and middle-income countries (LMICs). A lack of strong research evidence persists, however, about the most efficient and effective strategies to ensure optimal, sustained performance of CHWs at scale. To facilitate learning and research to address this knowledge gap, the authors developed a generic CHW logic model that proposes a theoretical causal pathway to improved performance. The logic model draws upon available research and expert knowledge on CHWs in LMICs.[from abstract]

Utilization of Community-based Health Information Systems in Decision Making and Health Action in Nyalenda, Kisumu County, Kenya

The development of comprehensive community based health information systems is increasingly becoming important for measuring and improving the quality of health services. Many developing countries including Kenya have made efforts to strengthen their national health information systems to provide information
for decision-making in managing health care services. The purpose of this paper is to explore how data collected at the community level is utilised by various stakeholders within the community in order to produce actionable information for decision making. [from abstract]

Integrating National Community-Based Health Worker Programmes into Health Systems: A Systematic Review Identifying Lessons Learned From Low-and Middle-Income Countries

Despite the development of national community-based health worker (CBHW) programmes in several low- and middle-income countries, their integration into health systems has not been optimal. Studies have been conducted to investigate the factors influencing the integration processes, but systematic reviews to provide a more comprehensive understanding are lacking. [from abstract]

Assessment of Non-Financial Incentives for Volunteer Community Health Workers – The Case of Wukro District, Tigray, Ethiopia

Volunteer community health workers (VCHW) are health care providers who are trained but do not
have any professional certification. They are intended to fill the gap for unmet curative, preventative, and health promotion health needs of communities. This study aims to investigate the non-financial incentives for VCHWs and factors affecting their motivation. [from abstract]

Deepening the Quality of Clinical Reasoning and Decision-Making in Rural Hospital Nursing Practice

Rural acute care nursing requires an extensive breadth and depth of knowledge as well as the ability to quickly reason through problems in order to make sound clinical decisions. This reasoning often occurs within an environment that has minimal medical or ancillary support. Registered nurses (RN) new to rural nursing, and employers, have raised concerns about patient safety while new nurses make the transition into rural practice. [from introduction]

Reclaiming Public Health Through Community-Based Monitoring: The Case of Maharashtra, India

Community-based monitoring and planning (CBMP) of health services in Maharashtra state, India represents an innovative participatory approach to improving accountability and healthcare delivery. This paper examines the successes and challenges of this process, discussing lessons learned and the potential for generalizing such initiatives to other sectors and regions. Maharashtra’s experiment could inform ‘communitization’ of health services in diverse contexts, as an alternative to
privatization and as a means to enhancing the ‘publicness’ of health services. [from summary]

Female Community Health Volunteers Service Utilization for Childhood Illness-Improving Quality of Health Services Only is Not Enough: A Cross-Sectional Study in Mid-Western Region, Nepal

Female Community Health Volunteers (FCHVs) are considered service providers for major health problems at the community level in Nepal. However, few studies have been conducted about the roles of FCHVs from the users’perspective. This study sought to examine the current status of FCHV service utilization and identify the determinants of caregivers’utilization of FCHVs’health services in the mid-western region of Nepal. [from abstract]

Strengthening Health Centre Committees as a Vehicle for Social Participation in Health in East and Southern Africa

Social participation in health systems has been a consistent element of post-independence health policies in east and Southern African (ESA) countries and central to primary health care (PHC). The Regional Network for Equity in Health in east and southern Africa (EQUINET) 2007 Regional Equity analysis highlighted that social participation and power are key for equitable health systems, and for reclaiming and using resources for health. [from introduction]

“Nothing For Us Without Us”: Establishing a Tuberculosis-Free Africa Through Community Action

African community activists have long recognized the need to strengthen the voices of African advocates and civil
society working to improve health and wellbeing across the continent. With funding from the United States Agency for
International Development (USAID), PATH helped former tuberculosis (TB) patients from five African countries to
build on the previous efforts of their colleagues to create a strong core organization—the Africa Coalition on
Tuberculosis (ACT!)—and then expand ACT!

The Significance of Community Engagement in Strengthening Health Systems

The Ebola epidemic has highlighted the importance of bridging trust and building common goals between the health profession and the communities they serve. [from introduction]

Considerations for Linking South Africa’s Youth-Friendly Services to its Community Health Worker Programme

In this article, we open the debate on whether or not South Africa’s Youth-friendly Services (YFS) programmes should be linked to community health worker (CHW) programmes. Both are important in South Africa’s efforts to re-engineer primary healthcare in the country. This article presents the pros and cons of linking the two programmes by incorporating YFS into the current list of CHW competencies. Also, we explore the alternative of training specialist CHWs to deliver YFS. [from abstract]